Long-Term Changes in Sexual Quality of Life in Patients With Axial Spondyloarthritis

a couple sitting on the couch holding hands
a couple sitting on the couch holding hands
Study authors assessed perception of sexual quality of life in men and women with axial spondyloarthritis, after a 5-year follow-up.

In patients with axial spondyloarthritis (axSpA), there were no significant changes in sexual quality of life (QOL) during a 5-year follow-up, despite evidence of a significant increase in comorbidities, according to study results published in Rheumatology.

Although there have been significant improvements in clinical outcomes of patients with axSpA, limited data are available on sexuality and sexual QOL in this population. The objective of the current study was to assess the long-term patient perception of sexual QOL in men and women with axSpA.

Study authors used the sexual QOL-Female (SQOL-F) questionnaire, a self-reported questionnaire to assess the relationship between sexual dysfunction in women and quality of life, to evaluate sexual QOL in women. Minor modifications in the questionnaire were implemented to assess sexual QOL in men.

The study included 245 patients (168 men; mean age, 46 years; mean disease duration, 11.9 years) with axSpA, from outpatient rheumatology clinics at Marina Hansens Hospital and Sørlandet Hospital in Norway. Data from the SQOL-F questionnaire at the 5-year follow-up were available for 221 patients.

At the 5-year follow-up vs baseline, patients had more comorbidities (0.95 vs 0.58, P ≤.001), lower C-reactive protein (5.34 vs 8.25, P <.001), lower disease activity, according to the Maastricht Ankylosing Spondylitis Enthesitis (1.30 vs 3.19, P <.001) and Bath Ankylosing Spondylitis Functional Index (3.03 vs 3.67, P =.003) scores, and significantly more patients were treated with biologic agents (40% vs 23%, respectively; P <.001).

For all patients combined, as well as for men and women separately, no statistically significant changes in sexual QOL sum score, and its subscore were found between baseline and 5-year follow-up, despite a significantly increased proportion of comorbidities, including cardiovascular, endocrine, and gastrointestinal disease.

Exercising for less than 1 hour weekly was found to be associated with a significantly lower sexual QOL score at the 5-year follow-up (B =-4.29; 95% CI, -8.55 to -0.04; P =.048), and age greater than 65 years was associated with deterioration in the sexual QOL subscore of Psychosexual Feelings (B =-0.12; 95% CI, -0.22 to -0.01; P =.028).

The study had several limitations, including SQOL-F data collection being available from a limited number of time points during the 5 years, potential differences between patients who attended and were lost to follow-up, and the inclusion of a small number of patients aged greater than 65 years.

“Our findings add evidence to the importance of suppressing inflammation in patients [with] axSpA to maintain and improve [health-related] QOL including [sexual] QOL,” the study authors concluded.


Berg KH, Rohde G, Pripp A, et al. Increased proportion of comorbidities but no deterioration of sexual QOL during a 5-year follow-up in patients with axSpA in the biologic treatment era. Rheumatology (Oxford). Published online January 7, 2021. doi:10.1093/rheumatology/keaa887